7.24 Agents of Hepatic Abscesses and Other Intra-Abdominal Infections Flashcards Preview

Microbiology > 7.24 Agents of Hepatic Abscesses and Other Intra-Abdominal Infections > Flashcards

Flashcards in 7.24 Agents of Hepatic Abscesses and Other Intra-Abdominal Infections Deck (47)
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1

Focal accumulations of debris and pus that may be caused by seeding of pyogenic organisms into a tissue or by secondary infections of necrotic foci

Abscesses

2

Postoperative; perforation of hollow viscus; appendicitis; diverticulitis; tumor; Crohn's disease; PID, generalized peritonitis

Intraperitoneal (subphrenic, right or left lower quadrant, interloop, paracolic, pelvic)

3

Trauma, ascending cholangitis, portal bacteremia

Hepatic

4

Trauma, hematogenous, infarction

Splenic

5

Trauma, pancreatitis

Pancreatic

6

Spread of renal parenchymal abscess

Perinephric

7

Anaerobic infection DOC

Metronidazole

8

Gram-negative DOC

3rd gen cephalosporins

9

Most common organism that is attributed to intraperitoneal abscesses
Most common anaerobic bloodstream isolate

Bacteroides fragilis

10

B fragilis TOC

Metronidazole
High dose penicillin

11

Found on B fragilis bacteria surface
Triggers septic response

Capsular polysaccharide complex

12

Localize abscess caused by B. fragilis

Indium-labelled WBCs and gallium

13

Contrast media for abscesses contiguous with or contained within diverticula, because they are particularly difficult to diagnose with scanning procedures

Barium enema

14

Mainstay management of intraabdominal infections

Drainage of abscess (less than 20cc/day)

15

Most important type of visceral abscess
Fever, chills, anorexia, RUQ pain, right-sided pulmonary symtoms
FUO

Pyogenic liver abscess

16

Main causative agent of pyogenic liver abscess

Klebsiella pneumoniae

17

Liver invasion by bacteria

Ascending infection int he biliary tract (ascending cholangitis)

18

In developing countries, the most common cause of pyogenic liver abscess

E. histolytica

19

Most common cause of pyogenic liver abscess among immunocompromised patients

Candida spp

20

Gram neg bacilli
Lactose fermenter
Very common in intraperitoneal or visceral abscesses

K. pneumoniae

21

Outer membrane protein that makes K. pneumoniae more invasive
Antiphagocytic activity

MagA

22

Sources of pyogenic liver abscess

Biliary
Pelvic/intraperitoneal
Hematogenous

23

Hematogenous pyogenic liver abscess

S. aureus, Streptococcus spp

24

Fever followed by RUQ and epigastric pain, jaundice, chills, nonspecific symptoms

Pyogenic liver abscess

25

Laboratory diagnosis of pyogenic liver abscess

Inc Alk Phosphatase
Hypoalbuminemia
Leukocytosis

26

Inhibits cell wall synthesis of G+ and some G-

Ampicillin

27

Irreversible inhibitors of protein synthesis
G+ and G-

Gentamicin

28

Nitro group is chemically reduced in anaerobic bacteria
Reative reduction products appear to be responsible for antimicrobial activity
Anaerobes

Metronidazole

29

Inhibits cell wall synthesis
Broad spectrum
Rash, drug fever

Cefotaxime
Ceftriaxone

30

Inhibits cell wall synthesis
Extended spectrum, better coverage for G-
Immediate hypersensitivity

Piperacillin/tazobactam

31

Inhibits cell wall synthesis
Broad spectrum
NVD skin rashes and reactions at infusion sites
Seizures in renal failure

Carbapenems (Ertapenem, imipenem, meropenem, doripenem)

32

Inhibits DNA replication by binding to DNA gyrase and topoisomerase IV

Ciprofloxacin
Levofloxacin
Moxifloxacin

33

Most common bacterial isolates from splenic abscesses

Streptococcal species

34

Seen fairly commonly, especially in patients with sickle cell hemoglobinopathy

Salmonella spp

35

Abdominal pain in LUQ, splenomegaly, fever and leukocytosis, left-sided chest findings

Splenic abscesses

36

Splenic abscess treatment

Splenectomy with adjunctive antibiotics

37

Commonly arise from ascending UTI

Retroperitoneal abscess

38

Most important risk factor for retroperitoneal abscess

Nephrolithiasis

39

3 most common causes of UTI

E. coli
Proteus spp
Klebsiella spp

40

Aerobic species, Gram -, lactose fermenter, has factors that promote adherence to uroepithelial cells

E. coli

41

Lactose non fermenter
Rapid-urease-positive organism
Found in association with large struvite - MgNO4SO4

Proteus spp

42

Hallmark is large fungal balls

Candida spp

43

Abdominal pain that radiates to the hips and thighs
Constant pain at grin regions

Psoas abscess

44

Commonly associated diseases of psoas abscess

Osteomyelitis
Pott's disease

45

Most likely to be isolated when a psoas abscess arsises from hematogenous spread or contiguous focus of osteomyelitis

S. aureus

46

Most common form of disease associated with amoeba

Colitis

47

Most common form of extraintestinal amoebiasis
RUQ pain, fever

Amoebic liver abscess